Knowledge, practices and perceptions of trachoma and its control among communities of Narok County, Kenya

Abstract

BackgroundTrachoma is the leading infectious cause of blindness in the world. It is commonly found in cultural groups with poor hygiene. Trachoma control includes Surgery, Antibiotics, Facial cleanliness and Environmental Improvement (SAFE). Potentially blinding and active trachoma are monitored using trachomatous trichiasis (TT) in adults and trachoma inflammation-follicular (TF) in children aged 1–9 years respectively. A cross-sectional study to assess the knowledge, practices and perceptions of trachoma and its control was conducted in the endemic communities in Narok County.MethodsQualitative methods were used for data collection. Using purposive sampling, 12 focus group discussions (FGDs) with single sex adult and young men and women groups of homogenous characteristics, 12 key informant interviews with opinion leaders and 5 in-depth interviews (IDIs) with trichiasis patients and 6 with persons who have undergone trichiasis surgery were conducted. Data was audio recorded, transcribed, coded and analyzed manually by study themes; knowledge, practices and perceptions of trachoma transmission, infection signs, prevention and control.ResultsMajority of the community members had knowledge of trachoma and its transmission. The practices that contributed to transmission of infection included: failure to wash faces and bathe regularly, sharing of water basins and towels for face washing, traditional methods of trachoma treatment and dirty household environment. Due to socio-cultural perceptions, toilets were unacceptable and use of bushes for human waste disposal was common. Poor perceptions on disease susceptibility, flies on children’s faces, latrine ownership and usage and separation of human and animal dwellings also played a role in the transmission of trachoma. Fear of loss of sight during surgery was a deterrent to its uptake and a desire to be able to see and take care of domestic animals promoted surgery uptake. Majority of the community members were appreciative of Mass Drug Administration (MDA) though side effect such as vomiting and diarrhoea were reported.ConclusionPoor practices and related socio-cultural perceptions are important risk factors in sustaining trachoma infection and transmission. Community members require health education for behavior change and awareness creation about surgery, MDA and its potential side effects for elimination of trachoma in Narok County, Kenya.Trial registration KEMRI SSC 2785. Registered 2 September 2014.

Knowledge, Attitudes, and Practices about Trachoma in Rural Communities of Tigray Region, Northern Ethiopia: Implications for Prevention and Control

“…The participants responded that trachoma can be prevented by using latrine, improve environmental sanitation, not using common towel, and washing hand and face with soap. Having knowledge on washing face, not sharing towels, and environmental sanitation was important on prevention of trachoma infection [ 11 ].…”

“…The odds of good attitudes on trachoma prevention and control among participants who had ever received health education were 2.1 times higher than participants who had not ever received health education about trachoma. Health education can help reducing misconceptions and changing cultural perceptions of communities on trachoma prevention and control [ 11 , 27 ]. Effective health education is the key to building the favorable attitudes on trachoma prevention and control among communities to achieve the goal of eliminating trachoma as a public health problem [ 28 , 29 ].…”

Use of validated community-based trachoma trichiasis (TT) case finders to measure the total backlog and detect when elimination threshold is achieved: a TT methodology paper

“…The high inter-observer agreement was attributed to strict recruitment criteria and prolonged apprenticeship period. A study conducted in Narok revealed that lay people can identify [ 12 ] which means that this task can be shifted even to unskilled workers. The World Health Organization standard trachoma guidelines do not recommend mandatory validation of TT graders [ 1 , 10 , 13 ].…”

“…The 2010 and 2014 impact surveys indicated that only 2 southern segments ( Figure 1 ) had remained endemic due to high prevalence of known environmental risk factors [ 11 ]. A survey segment was defined as an area with 100,000-200,000 people [ 12 ].These population size limits were within the limits of the trachoma intervention unit recommended by the World Health Organization [ 1 ]. The 2014 impact survey report indicated that the prevalence of TT in people 40+ years old in the two segments was 5.9%(95% CI: 4.0%-7.7%).…”

“…Narok aims to eliminate TT as a public health problem by the year 2020. A Knowledge, Attitudes and Practices (KAP) study conducted in Narok in 2014 revealed that lay people living in endemic areas know TT and have local names for it [ 12 ]. Usually TT is easy to diagnose hence formal validation of TT graders is not routinely done in prevalence surveys [ 13 ].…”